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The aim of this work is to compare the analgesic efficacy of laparoscopic transversus abdominis plane block, performed by the surgeon to ultrasound-guided erector spinae plane block, performed by the anesthetist, in patients with obesity undergoing bariatric surgery.
This is a randomized controlled trial which will include patients with obesity undergoing bariatric surgery. The patients will be randomly allocated into two groups: transversus abdominis plane block group and erector spinae plane block group. The block will be performed after induction of general anesthesia. Preoperative evaluation and preparation will include history-taking, laboratory investigation, fasting recommendations, and optimization of the medical status. The two groups will receive standard induction and maintenance of anesthesia. After the end of the operation, patients will receive standard care according to the local protocols and the enhanced recovery recommendations. Patients will be monitored according to the pain-related outcomes as well as hemodynamic parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Transversus abdominis block | Experimental | Patients in this group will receive Transversus Abdominis block guided by the laparoscope at the beginning of surgery. |
|
| Erector spinae block | Active Comparator | Patients in this group will receive Erector Spinae block guided by the ultrasound after induction of anesthesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transversus abdominis block | Procedure | The block will be performed by the surgeon by injecting local anesthetic at the beginning of surgery under the guidance of the laparoscope. |
| Measure | Description | Time Frame |
|---|---|---|
| Numerical rating scale | This is a scale for pain assessment which ranges between 0 and 10 with the highest level of pain having score 10 and lowest level of pain having score 0 | 24 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Consumption of analgesia | This is the total consumption of nalbuphine by the patient measured in milligrams | 24 hours after surgery |
| Heart rate | This is the number of heart beats measured as frequency of heart beats in one minute. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ahmed Hasanin, Professor | Professor of anesthesia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of medicine, Cairo University. | Cairo | Cairo Governorate | 11432 | Egypt |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D009765 | Obesity |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D050110 | Bariatric Surgery |
| D007442 | Intubation, Intratracheal |
| D015742 | Propofol |
| ID | Term |
|---|---|
| D049088 | Bariatrics |
| D000073319 | Obesity Management |
| D013812 | Therapeutics |
| D013514 | Surgical Procedures, Operative |
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| Erector spinae block | Procedure | The block will be performed by the anesthetist by injecting local anesthetic after induction of anesthesia under the guidance of the ultrasound. |
|
| Bariatric surgery | Procedure | Laparoscopic bariatric procedure will be performed |
|
| Endotracheal intubation | Device | An endotracheal tube will be inserted as a part of general anesthesia to all patients |
|
| Propofol | Drug | The patients will receive propofol for induction of anesthesia |
|
| 24 hours after surgery |
| Systolic blood pressure | This is the systolic arterial blood pressure measured in mmHg. | 24 hours after surgery |
| Vomiting | This is the incidence of vomiting after surgery measured as the frequency of patients with vomiting. | 24 hours |
| Diastolic blood pressure | This is the diastolic arterial blood pressure measured in mmHg. | 24 hours |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009422 | Nervous System Diseases |
| D058109 |
| Airway Management |
| D007440 | Intubation |
| D008919 | Investigative Techniques |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |